This past week was CRNA week. And since I’m training for this profession and it’s been awhile since I’ve posted, here it goes.
I believe that most of my readers know what a CRNA is: a certified registered nurse anesthetist. While there are some hospitals or surgery centers that only use anesthesiologists, the majority of hospitals in the United States also use or contract CRNAs. In some locations (especially in rural areas), the CRNA is the sole anesthesia provider. CRNAs are masters or doctorally prepared and thus go under intense full-time training typically from 24-36 months, depending on the program. They must have at least one year of critical care experience and often also take the GRE and CCRN before applying.
Currently, there are over 49,000 CRNAs in the US providing anesthesia in all settings and all kinds of surgery. Since I’m currently in Michigan, I know there are about 2,500 CRNAs practicing in Michigan alone.
I have to admit as a student registered nurse anesthetist, the program is tough and requires my full attention. Everything I learn in class is applied during clinical. Each day for clinical requires a full preparation, which requires a few hours of reading the night before, considering how each anesthetic is personalized for each patient, depending on their health history, anesthesia history, surgical history, medication/drug history, weight, height, labs, last time eaten, airway assessment, allergies, patient’s preference, and more. The expectation is that from day one that you’ll be an independent anesthesia provider and thus doing preoperative assessments (full head to toe assessment; are they optimized? What kind of anesthesia is appropriate, if any?), induction, maintenance, emergence and post op are all a part of the CRNAs role.
During the first semester, I felt this level of anxiety in my life that I had never experienced before. Even the smallest thing that goes wrong would make me question if I was able to do this program. Usually, if I did something wrong, I would tell myself that I did it wrong, and how to prevent that mistake the next time. However, some mistakes will be drilled into your head, which only furthers the anxiety (though I know the program is only hoping that it won’t ever happen again). Before each night, I could feel my ear pounding against my pillow. When I woke up, I was in sweats, waking up from a nightmare that I did something wrong. Then I’d force myself to eat at 4 am otherwise I knew I’d be hungry during the morning rush (because you never really know when you’ll be able to eat). Each day you have a plan, but you’re never sure exactly which plan you’re going with or questions you’d get asked that day. Sometimes I am prepared enough and other days I feel defeated. There’s a high level of expectation that you should know more than what you’re taught in class and that was a part of what makes it tough.
As the first semester waned and the second semester started, I compared what I knew back in August with what I knew at the beginning of January. In 4 months, I poured myself into these three 2-inches worth of notes and powerpoint. It’s impressive how much more I know now.
It’s been a month since the second semester started and I can say that I’ve reached a milestone: 50 intubations via laryngoscope today. From a year to 80-year-olds, orthopedics, dental, GI lab, plastics, burns, laparoscopic, c-section, healthy to very sick and so much more, it is incredible the range of patients that I’ve had the privilege to give anesthesia.
I’ve learned much but still have much to learn.
I have to say that I couldn’t do this program with the support of my family and friends and just as importantly, my classmates. They truly understand the turmoil that goes through the SRNA. We get each other’s backs and study together. How great is that.
The last thing before I end my update — considering that I’m in Flint, Michigan all the time now, I feel that I should address the water crisis. Drinking high amounts of lead, especially among kids under 6 whose brains are growing, will cause brain damage. I don’t know the effects among adults, but I’m sure drinking unsafe levels that over 1000x the acceptable level over a long period of time is not good for you.
It is true that people are drinking only bottled water. And bathing in bottled water (because it has caused rashes in many people). It is unfortunate that Flint’s emergency manager refused to acknowledge that Flint citizens’ water was affecting them negatively. The Flint City Council had voted to switch back to the Detroit River water but the emergency manager had vetoed this vote and denied this demand. It is terrible that only after scientific research done by a pediatrician at Hurley Medical Center that this problem becomes public in October 2015, before becoming an emergency in January 2016.
It is true that Flint has been devastated but now it is just so much worse. The majority of people who work in Flint travel from another town because people don’t feel safe. People don’t feel safe because there’s a high crime rate, most likely due to low income (the average person living in Flint makes $24k, which is HALF of the national average of $48k). When there is simply not enough funds to live, people will commit crimes to make ends meet. The low income is due to a lack of companies willing to be in Flint. But there’s a lack of companies because they don’t believe Flint has people capital. It is a terrible, terrible cycle. Having crazy high amounts of lead in water just adds fuel to the fire. Even fewer people will want to live in this town.
I’m disappointed that ‘saving the Michigan state funds’ or money, was more important than providing a safe source of a basic need: water. Money was more important than the wellbeing of over 100,000 people in the USA. It is hard to believe.
And one more thing — thank you to everyone who’s supported me on this website. Until next time.